Jump to content

Search the Community

Showing results for tags 'balance billing'.

  • Search By Tags

    Type tags separated by commas.
  • Search By Author

Content Type


  • Community Calendar


  • Announcements
    • PLEASE READ BEFORE POSTING / Board Announcements
    • Resources
  • Credit Repair
    • Credit Repair
    • Collections
    • Credit Bureaus/Reports/Scores
    • Identity Theft
  • Legal Issues
    • Is There a Lawyer in the House
    • Bankruptcy Q and A
  • Debt Validation
    • While You are In It Debt Validation Q and A
    • Debt Settlement
  • Loans and Banking
    • Obtaining Credit Cards, Auto Loans and Financing
    • Mortgages
    • Student Loans
    • Banking and Finance
  • Feedback and Non Credit Topics
    • Forum Feedback and Other Off Topic Stuff

Find results in...

Find results that contain...

Date Created

  • Start


Last Updated

  • Start


Filter by number of...


  • Start







Found 1 result

  1. Hi, I'll keep this short and to the point: State: OklahomaIssue: Insurance balance and potential of "balance billing" Background to Medical detail: (a) Surgery: Left sided Total Knee replacement (TKR) during March, 2011. (1) 1st TKR surgery done 3-15-11. (a) Post-Insurance balance, for surgery done 3-15-2011:...............$540 (2) 2nd TKR surgery done 3-30-2011 to "debride" infected knee (a) Post-Insurance balance, for surgery done 3-30-2011:...............$970 [original knee-prothesis was not deemed necessary to be replace with a clean prothesis] ....Balance claimed to be in "default":........................................................$1510 Notes: The balance of $540 under (1a) is a "Paid-in-full" account, and yes, easily documentable. The balance of $970 under (2a) is one I objected to, and remains the status quo for now. My Objection Rationale: I raised payment objections believing my EOB clearly stated Ive met all my medical cap obligations for the 2011 fiscal period and any further expenditures were a duplicate of the original. I didnt know what else to call it. Only later on, did I learn of properly paraphrasing it under the practices of "balance billing" and this issue was raised to both, the Hospital provider and the Insurance carrier. Hospital Administration admits they do balance billing. A quick reading of my EOB's from the first surgical date 3-15-2011, clearly states Ive reached my medical cap for claim year 2011 after Insurers paid the Hospital over 48K for this TKR experience so I find it hard to accept that my Insurance Carrier says the 2nd billing of $970 represents the reminder of my copayment being capped at that point. Enter "AMCOL SYSTEMS" to collect this amount of $1510 on 4-18-2013. (a) I issued a debt validation and a HIPPA authorization copy request on 5-10-2013 on 6-11-2013 I received from AMCOL in the mail: (1b) an Itemized statement listing all medical services rendered from the Surgical date 3-30-2011 and on. (this references the $970.00) (2b) An itemized statement listing all medical services rendered from the surgical date 3-15-2011 and on failed to materialize, from AMCOL. (This references the $540.00 part) (3b) AMCOL then proceeded to placed the amount of $1510.00 rather than the $970.00 that is in dispute over balance billing issues into the credit bureau files. I have NOT YET disputed this $$$ error to the credit bureaus. (Should I?) Question: If I dispute that the dollar amount of $1510 being reported and misrepresented by AMCOL to the credit bureau(s), would I have grounds for FDCPA violations against AMCOL and for FCBA violations against the hospital for providing a "paid up" account to a credit collector??..........(referencing the $540 that is paid up and yet end up in the hands of this CA. I thought "balance billing" was an outlawed activity, but seems to be a grey area, at least to my understanding. You may wonder how in the world did two accounts, for $540 and $970 respectively ever ended up in the hasnds of this collection agency??? Obviously, the hospital billing folks and the hospital accounts receivable folks arent communicating, they split my $540 between the two account balances so that it will look like Im paying on both of them at the same time instead of assigning the full $540 to the first account and arent responsive to my balance billing inquiries to get this correction made. To my way of thinking, I would think the first account with an ending balance of $540, can be easily and factually proved as being paid for in full, and is grounds for filing an FDCPA claim, in which case if AMCOL forks over $1k for this FDCPA error, I could then re-fork over that extra money to the hospital administrators and resolve the second account with an ending balance of $970 and end this balance billing feud. Or should I just report this to HIPPA violation to the proper authorities and forego an easy FDCPA violation (me thinks???) I'd appreciate being pointed out my weak arguments and how to strengthen this HIPPA quandry of mine. Thank you so much!!!
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.. For more information, please see our Privacy Policy and Terms of Use.